HIV/AIDS: Editor's Picks

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ARV medicine is free in Papua, but there are only two different types available. S. (14) has suffered from painful rashes and skin problems since she started her treatment, but there are no alternative ARV cocktails available.

Kinshasa, Democratic Republic of Congo | 09-06-2013
The problem of street children in Kinshasa continues to worsen, despite more than two thousand former street and orphaned children who have been housed and rehabilitated by a national government program. In the DR Congo, the street children are called “enfants sorciers,” meaning the witch kids who are usually victims of domestic violence, the HIV epidemic, early pregnancies, or suspected of practicing voodoo. Most of the children have confessed to pick-pocketing, regular drug use, expecially marijuana and sniffing petrol. A pilot project to rehabilitate thousands of children living on the streets of DR Congo is failing because government is excluding civil society from the rehabilitation program.Two years ago, the government began recruiting Kinshasa’s street kids and placing them into training centres under the auspices of the DR Congo National Service, to provide them trade skills, such as carpentry and tailoring. However following their graduation from life and trade skills training, the children often return to their old lives because there has been no planning by government on how the skills could be utilized by the kids to their benefit.

Two nurses insert an intravenous drip into Yulianus'* (23) hand. Yulianus has been undergoing ARV therapy for the past two years, but often forgets when he feels well. Feeling weak, with no appetite and coughing blood a local NGO recommended he should go to hospital. He was diagnosed with TB.

Many Papuans are reluctant to go to hospital as most of the staff is non-Papuan leading to cultural and linguistic misunderstandings. The upheaval and the high costs incurred for the family to stay in town or to visit them is another deterrent.

In the Papuan culture one will only seek medical attention when it is impossible to walk or work. HIV/AIDS is still a relatively new disease in the region, and people are still unaware of its modes of transmission and consequences.

29 January 2013. La Rinconada: A nurse tests a prostitute working in a brothel in La Rinconada, Ananea, Peru, on the HIV-AIDS. Around 1% of about 1,000 prostitutes in town get positive every year.
La Rinconada was a nice, quiet rural village in Peru’s Los Andes range twenty years ago. However, the economic crisis in the country and the discovery of gold changed the town completely during the nineties. Now, it is a crowded place where thousands of the poor from all over South America frequently immigrate looking for opportunity. The precious metal has transformed La Rinconada into a chaotic village of nearly 50,000 inhabitants (four times more than the past) with a serious lack of social services. The increase in the price of gold (25% last year and 600% in ten years) has pushed many more people to move up there.
Nowadays, the landscape in La Rinconada is full of metallic shelters built without official permits. There is no pavement, sewers and running water. It is full of rubbish and defecation everywhere. It is now a place with serious problems of alcoholism, drugs and crime. The police is nearly absent and illegal prostitution is always present. The use of mercury to separate gold from rock has created a high level of pollution that provokes aggressiveness among the population. This, added to the fact that La Rinconada is about 6,000 meters altitude, causes also breath sicknesses (especially among children) and the local clinic covers just 10% of the needs. Despite some apparent efforts of the local administration, the situation is getting worse year by year.
Photo by Albert González Farran.

While most of the Yemen was marking the rare 12/12/12 on Thursday by
participating in a highly publicized “Clean Up Yemen” effort, three young students
at the Lebanese International University in the capital of Sana’a, were attempting to
use the day’s events to draw attention to a crisis that couldn’t be more controversial
in a socially conservative country, HIV/AIDS awareness and the protection of those
affected by it.

A student at the Lebanese International University in Sana’a Yemen tapes a
poster promoting awareness about HIV/AIDS on a campus wall on Wednesday

A member of YPKM, a local NGO, demonstrates the use of a condom during an HIV and STD awareness raising campaign at a local market. These kind of campaigns are still very rare.

Sexual health awareness is extremely low among the Papuan population as a whole.

Indonesian health officials often blame cultural sex practices such as 'wife swapping' for the rapid spread of HIV in Papua, but transmigration and large resource extraction projects have fed the sex industry, which has also been a major driver of the spread of the disease. The exclusion of large parts of the indigenous populations from development and access to the market economy has led increasing levels of Papuan women to engage in prostitution. Poverty is such that transactions often take place in unregulated open air or street dwelling sites with no safety precautions. One NGO worker said that some very young girls sell their bodies for less than 50 cent, for which you cannot even buy a packet of cigarettes or condoms. In semi official prostitution establishments, immigrant prostitutes (usually wearing condoms) charge 20 Euro upwards.

HIV testing and ARV therpy in Wamena are free. Voluntary Counseling and Testing (VCT) in Wamena only started in 2007, at the initiative of a church sponsored clinic. This led to the public clinics and the hospital offering the service shortly afterwards. The latest statistics for the whole Jayawijaya region, from September 2012, show that 2504 (with a population of over 200,000) people have tested positive for the disease. However, the majority of cases stay undetected

Many people do not get tested due to the lack of services in their area, high travel costs or lack of roads. Local clinics (Puskesmas) outside of the city are often closed and the staff absent.

The prevalence rate among ethnic Papuans is almost twice as high as among the Indonesian newcomers . Contrary to the rest of Indonesia where the epidemic is mainly concentrated among high risk groups such as injection drug users and sex workers, in Papua transmission is almost entirely through heterosexual relations (97,1%) and has very much spread to the low-risk population.

Kinshasa, Democratic Republic of Congo | 09-06-2013
The problem of street children in Kinshasa continues to worsen, despite more than two thousand former street and orphaned children who have been housed and rehabilitated by a national government program. In the DR Congo, the street children are called “enfants sorciers,” meaning the witch kids who are usually victims of domestic violence, the HIV epidemic, early pregnancies, or suspected of practicing voodoo. Most of the children have confessed to pick-pocketing, regular drug use, expecially marijuana and sniffing petrol. A pilot project to rehabilitate thousands of children living on the streets of DR Congo is failing because government is excluding civil society from the rehabilitation program.Two years ago, the government began recruiting Kinshasa’s street kids and placing them into training centres under the auspices of the DR Congo National Service, to provide them trade skills, such as carpentry and tailoring. However following their graduation from life and trade skills training, the children often return to their old lives because there has been no planning by government on how the skills could be utilized by the kids to their benefit.

Kinshasa, Democratic Republic of Congo | 09-06-2013
The problem of street children in Kinshasa continues to worsen, despite more than two thousand former street and orphaned children who have been housed and rehabilitated by a national government program. In the DR Congo, the street children are called “enfants sorciers,” meaning the witch kids who are usually victims of domestic violence, the HIV epidemic, early pregnancies, or suspected of practicing voodoo. Most of the children have confessed to pick-pocketing, regular drug use, expecially marijuana and sniffing petrol. A pilot project to rehabilitate thousands of children living on the streets of DR Congo is failing because government is excluding civil society from the rehabilitation program.Two years ago, the government began recruiting Kinshasa’s street kids and placing them into training centres under the auspices of the DR Congo National Service, to provide them trade skills, such as carpentry and tailoring. However following their graduation from life and trade skills training, the children often return to their old lives because there has been no planning by government on how the skills could be utilized by the kids to their benefit.

Kinshasa, Democratic Republic of Congo | 09-06-2013
The problem of street children in Kinshasa continues to worsen, despite more than two thousand former street and orphaned children who have been housed and rehabilitated by a national government program. In the DR Congo, the street children are called “enfants sorciers,” meaning the witch kids who are usually victims of domestic violence, the HIV epidemic, early pregnancies, or suspected of practicing voodoo. Most of the children have confessed to pick-pocketing, regular drug use, expecially marijuana and sniffing petrol. A pilot project to rehabilitate thousands of children living on the streets of DR Congo is failing because government is excluding civil society from the rehabilitation program.Two years ago, the government began recruiting Kinshasa’s street kids and placing them into training centres under the auspices of the DR Congo National Service, to provide them trade skills, such as carpentry and tailoring. However following their graduation from life and trade skills training, the children often return to their old lives because there has been no planning by government on how the skills could be utilized by the kids to their benefit.

Kinshasa, Democratic Republic of Congo | 09-06-2013
The problem of street children in Kinshasa continues to worsen, despite more than two thousand former street and orphaned children who have been housed and rehabilitated by a national government program. In the DR Congo, the street children are called “enfants sorciers,” meaning the witch kids who are usually victims of domestic violence, the HIV epidemic, early pregnancies, or suspected of practicing voodoo. Most of the children have confessed to pick-pocketing, regular drug use, expecially marijuana and sniffing petrol. A pilot project to rehabilitate thousands of children living on the streets of DR Congo is failing because government is excluding civil society from the rehabilitation program.Two years ago, the government began recruiting Kinshasa’s street kids and placing them into training centres under the auspices of the DR Congo National Service, to provide them trade skills, such as carpentry and tailoring. However following their graduation from life and trade skills training, the children often return to their old lives because there has been no planning by government on how the skills could be utilized by the kids to their benefit.

Kinshasa, Democratic Republic of Congo | 09-06-2013
The problem of street children in Kinshasa continues to worsen, despite more than two thousand former street and orphaned children who have been housed and rehabilitated by a national government program. In the DR Congo, the street children are called “enfants sorciers,” meaning the witch kids who are usually victims of domestic violence, the HIV epidemic, early pregnancies, or suspected of practicing voodoo. Most of the children have confessed to pick-pocketing, regular drug use, expecially marijuana and sniffing petrol. A pilot project to rehabilitate thousands of children living on the streets of DR Congo is failing because government is excluding civil society from the rehabilitation program.Two years ago, the government began recruiting Kinshasa’s street kids and placing them into training centres under the auspices of the DR Congo National Service, to provide them trade skills, such as carpentry and tailoring. However following their graduation from life and trade skills training, the children often return to their old lives because there has been no planning by government on how the skills could be utilized by the kids to their benefit.

Kinshasa, Democratic Republic of Congo | 09-06-2013
The problem of street children in Kinshasa continues to worsen, despite more than two thousand former street and orphaned children who have been housed and rehabilitated by a national government program. In the DR Congo, the street children are called “enfants sorciers,” meaning the witch kids who are usually victims of domestic violence, the HIV epidemic, early pregnancies, or suspected of practicing voodoo. Most of the children have confessed to pick-pocketing, regular drug use, expecially marijuana and sniffing petrol. A pilot project to rehabilitate thousands of children living on the streets of DR Congo is failing because government is excluding civil society from the rehabilitation program.Two years ago, the government began recruiting Kinshasa’s street kids and placing them into training centres under the auspices of the DR Congo National Service, to provide them trade skills, such as carpentry and tailoring. However following their graduation from life and trade skills training, the children often return to their old lives because there has been no planning by government on how the skills could be utilized by the kids to their benefit.

Seventy year old Wairimu Gachenga shows lettuce that she gets from a local church to feed her family on 30 May 2013 in the Nairobi slum of Korogocho, Kenya. Once a week a group of grandmothers from the area get together to practice self defence techniques after one of them was raped in 2007. Rape of elderly woman has increased in Kenya as people believe that grandmothers have a lower risk of HIV compared to younger women. KAREL PRINSLOO.

An NGO worker shows samples of ARV medecine to senior high school students during an HIV/AIDS awareness raising workshop. Youngsters in Papua are mostly unaware of the risks of unprotected sex and children as young as eleven years old are HIV+.

A women's disfigured hands tell of a long history of loss. Traditionally Dani women amputate a finger everytime a close member of the family deceases.

The fact that HIV infection is higher among ethnic Papuans is representative of greater socio-economic inequalities. Much remains to be done to reach the United Nations Political Declaration on HIV/AIDS and the Millennium Development goals. In Papua, the severity of the situation has been completely underestimated by the authorities and so far, their response to the epidemic has been severely inadequate. In order to decrease dissatisfaction with their rule, a general attitude of the Indonesian government has been to provide local governments in Papua with large amounts of money. It is then assigned to various programs without proper preliminary research and subsequent monitoring. The actual causes of the problem however, are rarely tackled. The poor standards or complete lack of health services and education throughout the region not only facilitate the spread of the disease, they also severely impede any efficient response to the epidemic. Indeed, although the provincial governments have made HIV testing and treatment free, many Papuans do not have access to health care or education and are unlikely to be reached by awareness raising campaigns any time soon. In the meantime, the virus continues its deadly advance into the highlands.

Luweero, Uganda-March 10, 2013-
Involvement in the promotion of better health is central in the development of Uganda as a better nation. This includes clean hospitals and health centers, schools, wells and effective community outreach programs in which people receive free medication, health services and mosquito nets. But even with the strong government efforts in reducing mortality rates, the situation is still serious and dangerous in some areas of Uganda. Children are at especially high risk of vector borne diseases including malaria, as well as water-borne diseases including bacterial diarrhea. Maternal mortality is high in Uganda, and pregnancy is still the leading cause of death for young women ages 15 through 19. The picture shows a woman affected by HIV/AIDS, during the daily visit in Luweero general hospital.

Luweero, Uganda - March 10, 2013
Involvement in the promotion of better health is central in the development of Uganda as a better nation. This includes clean hospitals and health centers, schools, wells and effective community outreach programs in which people receive free medication, health services and mosquito nets. But even with the strong government efforts in reducing mortality rates, the situation is still serious and dangerous in some areas of Uganda. Children are at especially high risk of vector borne diseases including malaria, as well as water-borne diseases including bacterial diarrhea. Maternal mortality is high in Uganda, and pregnancy is still the leading cause of death for young women ages 15 through 19. The picture shows a young boy, Thomas,15 tears old affected by HIV/AIDS, during lying down the bed, in Luweero general hospital.

Luweero, Uganda - March 10, 2013
Involvement in the promotion of better health is central in the development of Uganda as a better nation. This includes clean hospitals and health centers, schools, wells and effective community outreach programs in which people receive free medication, health services and mosquito nets. But even with the strong government efforts in reducing mortality rates, the situation is still serious and dangerous in some areas of Uganda. Children are at especially high risk of vector borne diseases including malaria, as well as water-borne diseases including bacterial diarrhea. Maternal mortality is high in Uganda, and pregnancy is still the leading cause of death for young women ages 15 through 19. The picture shows a one month baby girl with evident signs of malnutrition.

Luweero, Uganda-March 10, 2013-
Involvement in the promotion of better health is central in the development of Uganda as a better nation. This includes clean hospitals and health centers, schools, wells and effective community outreach programs in which people receive free medication, health services and mosquito nets. But even with the strong government efforts in reducing mortality rates, the situation is still serious and dangerous in some areas of Uganda. Children are at especially high risk of vector borne diseases including malaria, as well as water-borne diseases including bacterial diarrhea. Maternal mortality is high in Uganda, and pregnancy is still the leading cause of death for young women ages 15 through 19. The picture shows a woman affected by HIV/AIDS, during the daily visit in Luweero general hospital.

Luweero, Uganda - March 10, 2013
Involvement in the promotion of better health is central in the development of Uganda as a better nation. This includes clean hospitals and health centers, schools, wells and effective community outreach programs in which people receive free medication, health services and mosquito nets. But even with the strong government efforts in reducing mortality rates, the situation is still serious and dangerous in some areas of Uganda. Children are at especially high risk of vector borne diseases including malaria, as well as water-borne diseases including bacterial diarrhea. Maternal mortality is high in Uganda, and pregnancy is still the leading cause of death for young women ages 15 through 19.The picture shows , a baby girl, affected by the guinea worm, in severe conditions, in Luweero general hospital. Guinea worm, is another serious pathology, in remote areas of Uganda.

Luweero, Uganda - March 10, 2013
Involvement in the promotion of better health is central in the development of Uganda as a better nation. This includes clean hospitals and health centers, schools, wells and effective community outreach programs in which people receive free medication, health services and mosquito nets. But even with the strong government efforts in reducing mortality rates, the situation is still serious and dangerous in some areas of Uganda. Children are at especially high risk of vector borne diseases including malaria, as well as water-borne diseases including bacterial diarrhea. Maternal mortality is high in Uganda, and pregnancy is still the leading cause of death for young women ages 15 through 19.The picture shows an old woman, affected by cerebral malaria, in severe conditions, in Luweero general hospital. Malaria, is devastating many areas of Uganda, like the Luweero region and government is trying to provide every family with several mosquito nets, to avoid serious situations.

Luweero, Uganda - March 10, 2013
Involvement in the promotion of better health is central in the development of Uganda as a better nation. This includes clean hospitals and health centers, schools, wells and effective community outreach programs in which people receive free medication, health services and mosquito nets. But even with the strong government efforts in reducing mortality rates, the situation is still serious and dangerous in some areas of Uganda. Children are at especially high risk of vector borne diseases including malaria, as well as water-borne diseases including bacterial diarrhea. Maternal mortality is high in Uganda, and pregnancy is still the leading cause of death for young women ages 15 through 19.The picture shows some medicines capable to fight secondary infections of HIV/AIDS.

Kampala, Uganda - March 10, 2013
Involvement in the promotion of better health is central in the development of Uganda as a better nation. This includes clean hospitals and health centers, schools, wells and effective community outreach programs in which people receive free medication, health services and mosquito nets. But even with the strong government efforts in reducing mortality rates, the situation is still serious and dangerous in some areas of Uganda. Children are at especially high risk of vector borne diseases including malaria, as well as water-borne diseases including bacterial diarrhea. Maternal mortality is high in Uganda, and pregnancy is still the leading cause of death for young women ages 15 through 19. The picture shows the procedure for the HIV/AIDS testing inside the Mulago hospital clinic lab.

Kampala, Uganda - March 10, 2013
Involvement in the promotion of better health is central in the development of Uganda as a better nation. This includes clean hospitals and health centers, schools, wells and effective community outreach programs in which people receive free medication, health services and mosquito nets. But even with the strong government efforts in reducing mortality rates, the situation is still serious and dangerous in some areas of Uganda. Children are at especially high risk of vector borne diseases including malaria, as well as water-borne diseases including bacterial diarrhea. Maternal mortality is high in Uganda, and pregnancy is still the leading cause of death for young women ages 15 through 19. The picture shows the procedure for the HIV/AIDS testing inside the Mulago hospital clinic lab.